Cystic teratoma on the floor of the mouth is infrequent disease and known as congenital origin. Teratoma has no sex distribution. Treatrnent of the cystic teratoma is completely surgical excision and recurrence is rare. The authors have experienced a case of cystic teratoma on the floor of the mouth in neonate. We reported this case with review of literatures.
Humans ; Infant, Newborn* ; Mouth* ; Recurrence ; Sex Distribution ; Teratoma*

Sudden cardiac arrest during epidural anesthesia is a rare but catastrophic complication. It was recently reported that occurs in one per 10,000 epidural anesthesia cases. We report one case of cardiac arrest in a healthy 45-year-old male patient undergoing relatively minor surgery. His preoperative blood pressure was 110-130/70-80 mmHg, heart rate 75-80 beats per minute, and oxygen saturation 98%. Immediately after tourniquet release, cardiac arrest was developed without warning signs. The patient was resuscitated by prompt precordial thump pacing, a fluid bolus, intravenous injection of atropine and ephedrine, and ventilated with oxygen. The procedure was completed and the patient recovered uneventfully.
Anesthesia, Epidural* ; Atropine ; Blood Pressure ; Death, Sudden, Cardiac* ; Ephedrine ; Heart Arrest ; Heart Rate ; Humans ; Injections, Intravenous ; Male ; Middle Aged ; Oxygen ; Surgical Procedures, Minor ; Tourniquets*

BACKGROUND/AIMS: Liver biopsy has been used to evaluate the degree of hepatic fibrosis in patients with chronic liver diseases. It is important to assess liver fibrosis when following the course of chronic liver diseases. Histopathological examination of percutaneous biopsy specimens is invasive and is also of questionable value because of the heterogenous distribution of pathological changes in the liver. Therefore, non-nvasive methods to determine the progress of liver fibrosis are needed. Serum hyaluronic acid and type IV collagen are known to be related to hepatic fibrosis. This study was performed to evaluate the clinical usefulness of serum hyaluronic acid and type IV collagen measurement as a differential point in patients with chronic liver diseases and early cirrhosis. METHODS: This study included 109 patients with chronic liver diseases caused by various etiologies. Liver biopsy and histopathological classification were done in all patients. Serum hyaluronic acid and type IV collagen were measured by one-tep sandwich binding protein assay and one-tep sandwich enzyme immunoassay. RESULTS: The concentrations of hyaluronic acid and type IV collagen in the early cirrhosis group (208.5+/-186.4 ng/mL, 242.1+/-162.8 ng/mL) were significantly higher (p<0.01) than those in the normal and fatty liver group (26.3+/-21.7 ng/mL, 79.2+/-28.8 ng/mL), mild chronic hepatitis group (22.8+/-15.4 ng/mL, 125.5+/-79.7 ng/mL), moderate to severe hepatitis group (66.3+/-60.5 ng/mL, 148.5+/-78.7 ng/mL). At the cutoff value of 100 ng/mL for hyaluronic acid and 200 ng/mL for type IV collagen, the sensitivities were 66.7% and 55.6%, and specifities were 82.9% and 89%, and diagnostic efficiencies were 78.9% and 80.7% respectively for discriminating patients with cirrhosis (4 points) from the mild to severe fibrosis (0~3 points). CONCLUSIONS: The serum levels of hyaluronic acid and type IV collagen may be sensitive markers of fibrotic process in chronic liver diseases and useful biochemical markers in differentiation of the patients with early cirrhosis from those with chronic liver diseases.
Biomarkers ; Biopsy ; Carrier Proteins ; Classification ; Collagen Type IV* ; Fatty Liver ; Fibrosis ; Hepatitis ; Hepatitis, Chronic* ; Humans ; Hyaluronic Acid* ; Immunoenzyme Techniques ; Liver Cirrhosis* ; Liver Diseases ; Liver*

PURPOSE: The purpose of the present study was to evaluate and analyze the clinical outcomes of the percutaneous repair of acute achilles tendon ruptures. MATERIALS AND METHODS: We performed a retrospective study on 14 patients with acute closed rupture of the Achilles tendon and they were managed with percutaneous repair from Jan. 2006 to Jun. 2007. The clinical outcomes were analyzed according to the causes of the injury and the postoperative functional performances. RESULTS: All the cases showed good or excellent outcomes, according to the Arner-Lindholm scale for the evaluation of acute Achilles tendon rupture. The average AOFAS score was 95.6 (range: 91-100). Nine patients were very satisfied and five patients were satisfied. They were satisfied especially because of the minimal postoperative scar. Two cases of sural nerve injury were reported as complications, and these cases fully recovered at postoperative three months. No evidence of surgical wound infection, necrosis of the wound or rerupture of the tendon was seen. CONCLUSION: The percutaneous repair of acute Achilles tendon rupture achieved high functional outcomes, a successful return to previous work and high satisfaction, with a relatively low incidence of complications.
Achilles Tendon ; Cicatrix ; Humans ; Incidence ; Necrosis ; Organic Chemicals ; Retrospective Studies ; Rupture ; Sural Nerve ; Surgical Wound Infection ; Tendons

We experienced a malignant hyperthermia in 24-year-old male with sevoflurane during the mandibular prognathism surgery. The malignant hyperthermia emerged 150 minutes after induction of general anesthesia using propofol, rocuronium, sevoflurane, N2O and O2. Sevoflurane has been reported that it can induce delayed onset of malignant hyperthermia under absence of succinylcholine. The prognosis of malignant hyperthermia is determined by early recognition, vigorous treatment and the time of dantrolene injection. In our case, when we suspected episode, all anesthetics were stopped and dantrolene injection was immediately given intravenously. The patient recovered normal temperature and consciousness without any complication.
Anesthesia, General* ; Anesthetics ; Consciousness ; Dantrolene ; Humans ; Male ; Malignant Hyperthermia* ; Prognathism ; Prognosis ; Propofol ; Succinylcholine ; Young Adult

BACKGROUND: The relationship between infection of microorganism and atherosclerosis has been studied because the pathophysiology after infection is similar to those of cell injury and/or lipid theory. Although there are many reports which described the relationships between the infection of chalamydia pneumoniae and the atherosclerosis. In Korea, even the prevalence of chlamydia infection has not been studied yet. This study was purposed on the prevalence of chlamydia infection and it's correlation to atherosclerosis. METHODS: 235 subjects were enrolled and age and sex adjusted subjects were divided into two groups, normal controls (n=43), atherosclerosis (AS, n=90) group:coronary artery disease (CAD, n=61) and cerebrovascular disease (CVD, n=29). Serum total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C) were measured, LDL-cholesterol (LDL-C) was calculated. Serum IgG chlamydia antibody were measured by ELISA method. RESULTS: TG was significantly higher in AS (162.51+/-100.04 mg/dL vs 122.91+/-63.31 mg/dL, mean+/-SD, p=0.019), and HDL-C was significantly higher in controls (47.30+/-9.88 mg/dL vs 39.38+/-8.29 mg/dL, p<0A65A>0.01). Levels of LDL-C and TC were not statistical significant. Serum IgG chlamydia antibody was positive in 29.8% (70/235), 30% (27/90) in AS group and 28% in controls and there was no statistical significance between groups (p=0.804). CONCLUSION: In conclusion, there was no significant differences in positivity of IgG chlamydia antibody in AS compared with that of controls. Overall positivity of chlamydia antibody was lower in Korea than in other country. It is still controversial whether Chlamydia pneumoniae is a primary etiologic agent of atherosclerosis or not. This study could not demonstrate the relationship between chlamydia infection and atherosclerosis in Korea. The effectiveness and indications of antichlamydial antibiotics for prevention of cardiovascular complications in atherosclerosis and overall chlamydia infection in general population will be needed in large scale trials.
Anti-Bacterial Agents ; Arteries ; Atherosclerosis* ; Chlamydia Infections ; Chlamydia* ; Chlamydophila pneumoniae* ; Cholesterol ; Coronary Artery Disease ; Enzyme-Linked Immunosorbent Assay ; Immunoglobulin G ; Korea ; Pneumonia ; Prevalence ; Triglycerides

Supraaortic stenosis is a localized or diffuse congenital narrowing of the ascending aorta at the levels of superior margin of the sinus of Valsalva, just above coronary arteries. Hemodynamically, it is a usually manifestated as aortic stenosis especially when it combined with subaortic membrane. And there is no case report of supraaortic stenosis combined with subaortic membrane which has aortic valvular reurgitation due to secondary change of dilated sinus of Valsalva by supraaortic ridge. We have experienced a case of aortic regurgitation associated with supraaortic ridge combined with subvalvular aortic membrane.
Aorta ; Aortic Valve Insufficiency* ; Aortic Valve Stenosis ; Constriction, Pathologic ; Coronary Vessels ; Membranes* ; Sinus of Valsalva

BACKGROUND: Ventricular function is one of the important prognostic factors in patients with coronary artery disease. Among noninvasive approaches for the evaluation of ventricular performance, radionuclide ventriculo-graphy has shown to be of particular values in the patients with myocardial infarction. We have evaluated ven-tricular function with ECG-gated blood pool scan (GBPS) in patients with myocardial infarction of different locations and compared right and left ventricular functions. METHOD: Left and right ventricular function was assessed with multigated blood pool scan in 49 patients at 2-3 weeks after acute myocardial infarction (anterior infarction=23, inferior infarction=19, and lateral infarction=7). Left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), maximal emptying rate, maximal filling rate, phase angle and full width at half maximum (FWHM) of phase angles were measured during rest. RESULTS: 1) LVEF was signifi-cantly lower in the patients with anterior myocardial infarction (32.2%) than that of inferior (46.5%, p<0.001) or lateral infarction (45.5%, p<0.05), but not different between inferior and lateral infarction. 2) RVEF was significantly lower in the patients with inferior myocardial infarction (24.6%) than that of anterior (30.5%, p<0.05) or lateral infarction (36.1%, p<0.001), and RVEF of anterior infarction was significantly lower than that of lateral infarction (p<0.05). 3) Phase angle and FWHM of left ventricle and right ventricle phase histogram were not significantly different among the patients groups with different infarct sites. CONCLUSIONS: Ventricular function was differently affected by different infarct sites. Inferior infarction resulted in a greater reduction in right ventricular ejection fraction. In contrast, LVEF was greatly depressed in anterior infarction than in inferior infarction.
Coronary Artery Disease ; Heart Ventricles ; Humans ; Infarction ; Inferior Wall Myocardial Infarction ; Myocardial Infarction ; Stroke Volume ; Ventricular Function ; Ventricular Function, Left ; Ventricular Function, Right*

PURPOSE: This study was designed to review the results of 2nd and 3rd kidney transplantation at our center. METHODS: Total 1,500 patients who had undergone kidney transplantation from 1968 to Aug 2005 at the Catholic Medical Center were retrospectively analyzed. The graft and patient survival were determined using Kaplan-Meier actuarial survival curves, compared with those of first transplant and assessed for significance using the log rank test. RESULTS: The patient of 2nd transplantation was 77 cases (male 55, female 22, mean age: 48.9+/-2.4 years) and 3rd transplantation was 5 patients (male 4, female 1, mean age 46.8+/-6.0 years). The 82 kidneys included from living donors in 67 patients and from cadaveric donors in 15 patients. The most common cause of renal failure of retransplanted kidney was chronic GN (2nd: 62 cases (80.5%), 3rd: 5 cases (100%)). The immunosuppressive regimen was mainly based on cyclosporine (2nd: 61 cases (79.2%), 3rd: 3 cases (60%)). The mean duration of the second transplantation from the first was 89.0 months and the third transplantation from the second was 32.7 months. There were 16 cases of death patients and the main cause of death was infection and cardiovascular events. The graft survival of 2nd & 3rd transplantation in 1 year were over 80%. CONCLUSION: Renal retransplantation is safe, effective, and the treatment of choice in patients with failed previous kidney transplantation for patient's quality of life and not associated with increased mortality retransplantation. The results of graft survival for retransplantation seem to be excellent for primary transplantation under cyclosporine or tacrolimus-based immunosuppression. The use of the potent and appropriate immunosuppression and surgical technique for retransplantation could help to improve better results.
Cadaver ; Cause of Death ; Cyclosporine ; Female ; Graft Survival ; Humans ; Immunosuppression ; Kidney Transplantation* ; Kidney* ; Living Donors ; Mortality ; Organ Transplantation* ; Quality of Life ; Renal Insufficiency ; Retrospective Studies ; Tissue Donors ; Transplants*

No abstract available.
Education*